Surgical apparatus

ABSTRACT

A surgical apparatus includes a combination of a drill guide and a bone fixation device. The bone fixation device includes a plurality of screw receiving apertures extending therethrough. The drill guide includes a top face and a plurality of drill apertures extending from the top face through the drill guide. The drill apertures of the drill guide are arranged such that the drill apertures can be separated into two groups by an imaginary dividing line, and, if a separation between the two groups in the plane of the top face and normal to the dividing line were increased by a distance d, then the arrangement of the drill apertures would match, or otherwise be aligned with, that of the screw receiving apertures.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of Great Britain Patent ApplicationNo. GB1413387.0, filed on Jul. 29, 2014, which is hereby incorporated byreference in its entirety.

TECHNICAL FIELD

The present disclosure is related to a surgical apparatus and method ofextending a length of a bone.

BACKGROUND

It is often desired to increase the length of a bone. This is typicallyachieved by cutting the bone into two portions with a bone saw. Thesurgeon then holds the two portions of the bone apart by a distanceequal to the desired increase in length of the bone. While holding thetwo bone portions in position, the surgeon places a bone fixation plateagainst the bone, drills screw receiving recesses in the bone throughscrew receiving apertures in the bone fixation device, and then finallyscrews the bone fixation plate to the bone. This procedure requires aconsiderable amount of manual dexterity on the part of the surgeon,while also making the operation time consuming, thus increasing the riskof complications, such as infection. Additionally, the surgeon mayrequire several attempts at drilling the screw receiving recesses in thecorrect positions in the bone, which weakens the bone.

SUMMARY

The present disclosure relates to a surgical apparatus. Moreparticularly, but not exclusively, the present disclosure relates to asurgical apparatus comprising a bone fixation device comprising aplurality of screw receiving apertures extending therethrough and adrill guide comprising a top face and a plurality of drill aperturesextending from the top face through the drill guide. The drill aperturesare arranged such that the drill apertures are divided into two groupsby an imaginary dividing line, such that if the two groups are separatedfrom one another in a direction normal to the imaginary dividing line,in the plane of the top face, all of the drill apertures would besimultaneously aligned with all of the screw receiving apertures.

One aspect of the present disclosure provides a surgical apparatuscomprising a combination of a drill guide and a bone fixation device.The bone fixation device includes a plurality of screw receivingapertures extending therethrough. The drill guide includes a top faceand a plurality of drill apertures extending from the top face throughthe drill guide. The drill apertures of the drill guide are arrangedsuch that the drill apertures can be separated into two groups by animaginary dividing line. If a separation of a distance d between the twogroups occurs, in the plane of the top face and normal to the imaginarydividing line, then the arrangement of each of the drill apertures wouldbe aligned with each the screw receiving apertures.

The surgical apparatus according to the disclosure considerablysimplifies the surgical procedure of lengthening a bone. The drill guidecan be placed against the bone and recesses can be drilled in the bonethrough the drill apertures. The bone can then be cut where two cut endsof the bone are then separated by a distance d. Once the two cut ends ofthe bone are separated by the distance d, the arrangement of therecesses in the bone will match the arrangement of the screw receivingapertures of the bone fixation device. The bone fixation device can thenbe secured to the bone, such as with one or more screws.

The amount of dexterity required on the part of the surgeon isconsiderably reduced. Further, use of the surgical apparatusconsiderably speeds up the procedure and increases the reliability withwhich the surgeon can correctly drill the recesses in the bone.

At least one of the drill guide and the bone fixation device may be aplate.

The drill guide may further include a separation plate extendingtherefrom, where the thickness of the separation plate is equal to thedistance d.

The screw receiving apertures may be arranged along a line. The screwreceiving apertures may be equally spaced along the line. Alternatively,the screw receiving apertures may be unequally spaced along the line.

The surgical apparatus may include a saw guide extending from the drillguide. The saw guide may be configured to be detachable from the drillguide. The drill guide may include a first portion and a second portion,where each portion includes one drill aperture group. The first portionand the second portion may be connected to one another by a separationmechanism, configured for adjusting the separation between the twoportions.

A further aspect of the disclosure provides a method of extending thelength of a bone with a surgical apparatus including a drill guide and abone fixation device. The method includes providing a surgical apparatusand positioning the drill guide against a bone. The drill guide includesa first group and a second group of drill apertures. A first group and asecond group of recesses are drilled in the bone, through the respectivefirst group and the second group of drill apertures. The bone is cutinto two portions, such that each of the two portions includes arespective one of the first group and the second group of apertures. Thetwo portions of the bone are separated from one another. A separationplate is inserted in between the two portions of the bone to separatethe two bone portions from one another by a distance d. The bonefixation device is arranged on the bone, such that the first group andthe second group of the screw receiving apertures are aligned with therespective first group and the second group of recesses in the bone. Afastener is inserted through each of the first group and the secondgroup of screw receiving apertures and into the respective first groupand the second group of recesses, such that the bone fixation device isattached to the bone.

Inserting the fastener may include inserting a screw through each of thefirst group and the second group of screw receiving apertures and intothe respective first group and the second group of recesses, such thatthe bone fixation device is attached to the bone.

The above features and advantages and other features and advantages ofthe present teachings are readily apparent from the following detaileddescription of the best modes for carrying out the present teachingswhen taken in connection with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1( a) is a schematic perspective view of a surgical apparatusincluding a drill guide, having drill apertures, and a bone fixationdevice, having screw receiving apertures.

FIG. 1( b 1) is a schematic plan view of the drill guide, illustratingan imaginary dividing line, separating the drill apertures into a firstgroup of drill apertures and a second group of drill apertures.

FIG. 1( b 2) is a schematic plan view of the drill guide and the bonefixation device, with the drill guide illustrating the first group ofdrill apertures spaced a distance d from the second set of apertures, ifseparated from one another along the imaginary dividing line, such thatthe drill apertures are simultaneously alignable with the screwreceiving apertures of the bone fixation device.

FIG. 2( a) is a schematic side view of the drill guide arranged againsta bone, with recesses drilled in the bone through the drill apertures ofthe drill guide.

FIG. 2( b) is a schematic side view of a separation plate insertedbetween two cut ends of the bone.

FIG. 2( c) is a schematic side view of the separation plate insertedbetween the two cut ends of the bone and the bone fixation plate placedagainst the bone, with all of the screw receiving apertures in alignmentwith all of the recesses in the bone, and with a screw being insertedinto one of the screw receiving apertures.

FIG. 3 is a schematic perspective view of a further embodiment of adrill guide of a surgical apparatus according to the disclosure.

FIG. 4 is a schematic perspective view of a further embodiment of adrill guide of a surgical apparatus according to the disclosure.

FIG. 5 is a schematic side view of a further embodiment of a drill guideof a surgical apparatus according to the disclosure.

DETAILED DESCRIPTION

Referring to the drawings, wherein like reference numbers refer to likecomponents throughout the several Figures, a surgical apparatus 1 isshown schematically in FIG. 1. The surgical apparatus 1 comprises adrill guide 2 and a bone fixation device 3. In this embodiment both thedrill guide 2 and the bone fixation device 3 are plates.

The drill guide plate 2 has a length L, width and thickness. Thethickness of the plate 2 is greater than its width. The drill guideplate 2 is typically made from surgical steel or other non-deformablematerial. Extending from a top face 4 of the drill guide 2 through thedrill guide 2 is a plurality of apertures 5.

The bone fixation device 3 comprises a plate having a plurality of screwreceiving apertures 6 extending therethrough. The bone fixation device 3is also typically comprises a surgical steel.

As shown in FIG. 1( b 1), the drill apertures 5 can be divided intofirst and second groups 7, 8 by an imaginary dividing line 9. Theimaginary dividing line 9 is imaginary in the sense that it providesfor, or otherwise divides, the drill apertures 5 into the first andseparate groups 7, 8. The imaginary dividing line 9 may be a straightline. Further, the imaginary dividing line 9 may be normal to the lengthL of the drill guide plate 2. As shown in FIG. 1( b 2), the screwreceiving apertures 6 may be dividing into a first group and a secondgroup 7 a, 7 b. If a separation of a distance d between the two groups7, 8 were to occur, in the plane of the top face 4 normal to thedividing line 9 such that the drill guide plate 2 is ‘extended’ (asshown in FIG. 1( b 2), then the arrangement of the drill apertures 5would match the arrangement of the screw receiving apertures 6. In otherwords if one were to arrange the bone fixation plate 3 next to the‘extended’ drill guide plate 2, then the two sets of apertures 5, 6would line up (i.e., the first groups 7, 7 a would be aligned with oneanother and the second groups 8, 8 a would be aligned with one another)so that fasteners 20, such as screws, may be passed through the drillapertures 5, into the screw receiving apertures 6.

FIGS. 2( a) to 2(c) show the surgical apparatus 1 according to thedisclosure, in use.

In a first step (shown in FIG. 2( a)) the drill guide plate 2 isarranged against a bone 10. A surgeon drills recesses 11 in the bone 10through the drill apertures 5. The recesses 11 may be divided into afirst group and a second group 7 b, 8 b, corresponding to the firstgroup 7 and the second group 8 of drill apertures 5 in the drill guideplate 2. The drill guide plate 2 is then removed before the surgeon cutsthe bone 10 into two portions.

The surgeon may then insert a separation plate 12 between the two cutends of the bone 10, thus separating the two bone portions by thethickness d of the separation plate 12. This is shown in FIG. 2( b).

In a next step, shown in FIG. 2( c), the bone fixation plate 3 is placedagainst the bone 10. Provided a separation plate 12 of the correctthickness t has been used, the recesses 11 in the bone 10 will bealigned with the screw receiving apertures 6 in the bone fixation plate3. More specifically, the first group 7 a of the screw receivingapertures 6 would be aligned with the first group 7 b of recesses 11 andthe second group 8 a of the screw receiving apertures 6 would be alignedwith the second group 8 b of the recesses 11 in the bone 10. The bonefixation plate 3 may then be screwed to the two bone portions 10, byinserting the fasteners 20 through the aligned apertures 6 and recesses11. Then, the separation plate 12 may be removed, completing theprocedure.

Shown in FIG. 3 is an alternative embodiment of a drill guide 2 of asurgical apparatus 1 according to the disclosure. As with the embodimentof FIG. 1, the drill guide 2 is a plate with a plurality of drillapertures 5 extending through the plate 2. Connected to the plate 2 is asaw guide 13. The saw guide 13 can be removed from the drill guide plate2 for cleaning Further, extending from the drill guide plate 2 is aseparation plate 12 which has a thickness d.

The method of use of the drill guide plate 2 of FIG. 3 is similar tothat described above. In a first step, the drill guide plate 2 is placedagainst the bone 10 and recesses 11, drilled in the bone 10 through thedrill apertures 5. Before the drill guide plate 2 is removed, however, abone saw (not shown) is positioned in the saw guide 13. The bone saw isused to score a mark on the bone 10. The drill guide plate 2 is thenremoved and the surgeon cuts through the bone 10 at the score mark,dividing the bone 10 into two portions. The drill guide plate 2 is thenrotated, and the separation plate 12 inserted between the two cut endsof the bone 10, separating the two bone portions 10 by a distance d. Aspreviously explained, with reference to FIG. 2( c), the bone fixationplate 3 is then placed against the bone 10 with the screw receivingapertures 6 of the bone fixation plate 3 aligned with the recesses 11 inthe bone 10. The bone fixation plate 3 can then be screwed to the bone10 with bone fixation screws 20 before finally the separation plate 12is removed from a gap, defined between the two cut ends of the bone 10,which are separated by the distance d.

Shown in FIG. 4 is a further embodiment of a drill guide 2 of a surgicalapparatus 1 according to the disclosure. In this embodiment the drillguide 2 comprises first and second portions 14, 15, each of whichcomprises one of the groups 7, 8 of drill apertures 5. The two portions14, 15 are connected together by a separation mechanism 16 for adjustingthe separation between the two portions 14, 15. In this embodiment theseparation mechanism 16 comprises a threaded rod 17. Each of theportions 14, 15 comprise a corresponding threaded aperture 18, 19, intowhich the rod 17 is received. Each complete turn of one of the portions14, 15 about the rod 17 separates the two portions 14, 15 by apredetermined distance. An optional saw guide 13 can be attached to thedrill guide 2.

In use, the drill guide 2 is arranged with the two portions 14, 15abutting one another. One of the portions 14, 15 is then turned aboutthe rod 17 until the arrangement of the drill apertures 5 matches thearrangement of the screw receiving apertures 6 of the bone fixationdevice 3. By counting the number of turns, the surgeon can calculate thethickness d of separation plate 12 required.

Shown in FIG. 5 is a further embodiment of a drill guide 2 according tothe disclosure. The drill guide 2 comprises first and second portions14, 15 each having a group 7, 8 of drill apertures 5 extendingtherethrough. A separation mechanism 16 connects the two portions 14, 15together. The separation mechanism 16 comprises a U shaped support 20having first and second springs 21, 22 connected thereto. Each spring21, 22 is connected to a respective portion 14, 15, as shown. Thesprings 21, 22 urge the two portions 14, 15 toward one another.

In use, separation plates 12 of different thicknesses are insertedbetween the two portions 14, 15 until a correct separation plate 12 isfound which makes the arrangement of the apertures 5 of the drill guide2 match the arrangement of the screw receiving apertures 6 of the bonefixation device 3 (FIGS. 1( b 2) and 2(c)). The correct separation plate12 is then removed. With the separation plate 12 removed, the twoportions 14, 15 are urged toward one another under the biasing action ofthe springs 21, 22. The drill guide 2 is then used, as previouslydescribed herein. When the two cut ends of the bone 10 are separated,the correct separation plate 12, identified previously, is insertedtherebetween.

In all of the above embodiments, the apertures 5, 6 in the drill guideplate 2 and the bone fixation device 3 are arranged along respectivelines. The screw receiving apertures 6 in the bone fixation device 3 maybe equally spaced. In an alternative embodiment the screw receivingapertures 6 may be unequally spaced. In alternative embodiments morecomplex arrangements of apertures 6 may be employed.

In the above embodiments the bone fixation device 3 is a plate. Inalternative embodiment the bone fixation device 3 may be a more complexstructure. For example the bone fixation device 3 may comprise aplurality of substantially spherical screw receiving members connectedtogether by receiving arms. Each screw receiving member has a screwreceiving aperture 6 extending therethrough.

While the best modes for carrying out the many aspects of the presentteachings have been described in detail, those familiar with the art towhich these teachings relate will recognize various alternative aspectsfor practicing the present teachings that are within the scope of theappended claims.

1. A surgical apparatus comprising: a drill guide including a top faceand a plurality of drill apertures extending from the top face throughthe drill guide; wherein the plurality of drill apertures are arrangedin a first group and a second group of drill apertures, such that thefirst group of drill apertures may be separated from the second group ofdrill apertures by an imaginary dividing line; and a bone fixationdevice configured to be attached to bone, the bone fixation deviceincluding a plurality of screw receiving apertures extendingtherethrough; wherein the plurality of screw receiving apertures arearranged in a first group and a second group of screw receivingapertures; and wherein the first group and the second group of drillapertures are configured such that if the first group and the secondgroup are separated from one another by a distance, in a plane of thetop face and normal to the imaginary dividing line, the first group ofdrill apertures are alignable with the first group of screw receivingapertures and the second group of drill apertures are simultaneouslyalignable with the second group of screw receiving apertures.
 2. Thesurgical apparatus as claimed in claim 1, wherein at least one of thedrill guide and bone fixation device is a plate.
 3. The surgicalapparatus as claimed in claim 1, wherein the drill guide furtherincludes a separation plate extending therefrom, wherein the separationplate has a thickness equal to the distance.
 4. The surgical apparatusas claimed in claim 1, wherein the plurality of the screw receivingapertures are arranged along a line.
 5. The surgical apparatus asclaimed in claim 4, wherein the plurality of the screw receivingapertures are equally spaced along the line.
 6. The surgical apparatusas claimed in claim 4, wherein the plurality of the screw receivingapertures are unequally spaced along the line.
 7. The surgical apparatusas claimed in claim 1, further comprising a saw guide extending from thedrill guide plate.
 8. The surgical apparatus as claimed in claim 7,wherein the saw guide is configured to be detached from the drill guide.9. The surgical apparatus as claimed in claim 1, wherein the drill guideincludes a first portion and a second portion, wherein each of the firstportion and second portions include one of the first group and thesecond group of drill apertures; wherein the first portion and thesecond portion are operatively connected to one another by a separationmechanism; and wherein the separation mechanism is configured foradjusting the distance between the two portions.
 10. A method ofextending the length of a bone with a surgical apparatus including adrill guide and a bone fixation device, the method comprising:positioning the drill guide against a bone, wherein the drill guideincludes a first group and a second group of drill apertures; drilling afirst group and a second group of recesses in the bone through therespective first group and the second group of drill apertures; cuttingthe bone into two portions, such that each of the two portions of thebone includes a respective one of the first group and the second groupof recesses; separating the two portions from one another; inserting aseparation plate between the two portions of the bone, such that the twobone portions are separated from one another by a distance; arrangingthe bone fixation device on the bone, such that the first group and thesecond group of the screw receiving apertures are aligned with therespective first group and the second group of recesses in the bone; andinserting a fastener through each of the first group and the secondgroup of screw receiving apertures and the respective first group andsecond group of recesses, such that the bone fixation device is attachedto the bone.
 11. The method of claim 10, further comprising removing theseparation plate from between the two portions of the bone after thebone fixation device is arranged on the bone.